Surgical scrub brush



Dec. 4, 1962 P. c. HoFsTRA ETAL 3,066,346

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2 I H H Dec. 4, 1962 P. c. HoFsTRA ETAL 3,066,346

SURGICAL SCRUB BRUSH Filed Dec. 22, 1961 2 Sheets-Sheet 2 NVENTOR. pe c. HorsrRA YHA Y J. ENGELSHER B United States Patent Office 3,066,346 Patented Dec. 4, 1962 3,066,346 SURGICAL SCRUB BRUSH Peter C. Hofstra, 149 Haledon Ave., Paterson, NJ., and Harvey J. Engelsher, 245 Rumsey Road, Yonkers, N.Y. Filed Dec. 22, 1961, Ser. No. 162,123 1 Claim. (Cl. 15-512) This invention relates to a novel and eficient surgical scrub brush for providing highly aseptic digital preparations.

It is the object of this invention to provide an efficient and novel scrub brush for use in preparing aseptic surfaces in order to enhance the clinical safety in operative procedures.

In particular, the object of this invention is to provide a scrub brush capable of reaching the intricate and complex topographical features of the surgeons hands as well as the hands of the operative personnel. A still further object of this invention is to provide a scrub brush that assures complete surgical preparation employing much simpler regimen of scrubbing.

'Ihis invention pertains to the use of a composite construction comprising a predetermined array and assembly of components, particularly the arrangement of bristles, with ancillary provisions for introduction of cleansing fluids and detergents and cuticular debridement by means of a mechanical edge.

A principal feature of this invention is the arrangement of the bristles placed in such a manner as to provide effective coverage over the most complex digital members, as well as provision for reaching the most inaccessible folds and crevices involved in the prehensile construction. Of particular interest to this invention is the use of a variety of natural and synthetic bristles particularly those endowed with an extremely low polarity or adhesion to dirt and bacteria. Additionally, the scrub brush of this invention is provided wtih appropriate channels for assuring a steady supply of active soap or detergent throughout the entire brush, thus assuring complete and effective coverage of the skin during the scrubbing process.

In performing a surgical scrubbing procedure, the actual mechanical abrasive action of bristles is the most irnportant factor in producing surgically clean hands. While soap and other antiseptic scrubbing detergents supplement the scrubbing procedure, the actual abrasive action of the bristles in removing embedded particles of dirt, dead epithelial tissue and other potentially virulent debris, remains the most difficult operation. A conventional square brush fails to reach or get into the angles and folds between the fingers. The actual angle and the proximal surfaces of the ngers are not properly reached by the bristles and hence represent an unscrubbed hazard in that these regions are potential areas of viable contamination. In addition, as each finger or digital component is scrubbed, the regimen of surgical scrubbing preparation considers the fingers as having four sides. With this concept in mind, therefore, certain areas of the fingers are scrubbed less than others. Since fingers are cylindrically shaped, and the brush is straight, it is anatomically incorrect for attaining the necessary or intended degree of asepsis. In cleaning fingernails, an orange stick is usually packed with each brush or is in another receptacle containing only orange sticks. In many cases, the orange sticks by being boiled and used over and over, develop soft tips which are inadequate for the proper cleaning of the nails. The construction ofthe surgical brush of this invention is made in such a manner as to eliminate the above inadequacies.

Another object of the invention is to provide new and improved brush means for cleaning hands and fingers.

Another object of the invention is to provide new and improved surgical brush means for cleaning hands and lingers.

Another object of the invention is to provide new and improved surgical brush means including finger nail cleaning means connected thereto.

Another object of the invention is to provide new and improved surgical brush means having a removable container for cleaning solutions such as soap.

Another object of the invention is to provide new and improved surgical brush means having a removable handle.

The accompanying drawings illustrate a preferred embodiment of our invention, but should not be deemed to limit the scope of our invention to any particular dimensions, proportions or similar details shown therein.

FIG. l is a side view of an embodiment of the invention.

FIG. 2 is a top FIGS. 3, 4 and of the invention.

Referring to the figures there is shown an arrangement of exterior bristles 1 and interior bristles 2- mounted in a hollow cylindrical bristle back or tube 3. To the back is attached a handle frame 4 through an engaging channel 5 constructed with a T slot that assures a secure attachment of the handle to T projection of the brush proper. On the handle are provided nail cleaner edges 6, 6 and a soap cartridge 7. The handle 4 is preferably locked to tube 3 with locking pins 10, 11. Bristles 12, 13 extend out the ends of tube 3 in a direction parallel the axis of tube 1. The soap, detergent or other cleaning material container 7 is preferably mounted in or connected to the handle. The container 7 may be a collapsible tube like a tooth paste tube with caps or valves 30 at one or both ends. The container 7 may be held in place in a holding groove or recess in the handle with flexible holding fingers 16 and 17 or other equivalent holding means. Alternatively, the container may be an integral part of the handle and equipped with valves or caps so that the container may be recharged. Also, provision may be made for connecting the soap supply to the interior central portion of the brush.

In the cylindrical brush proper, the exterior and interior bristles provide a simultaneous coverage of each digital member and its adjacent anatomical component. In addition, bristles are placed along the edge ofthe brush to provide a complete coverage. In the illustration, the interior bristles are constructed to provide a gradual constriction or taper extending through the side view such that the widest interior dimension is approximately 3%; inch diameter which tapers into a 1A inch diameter at the deep or further end. This taper provides a more rigorous scrubbing while at the same time making a more proximate fit to the usual taper of the fingers. The exterior bristle provides a simultaneous scrubbing of the adjacent finger, while the edge bristles, which would point away plan view of the embodiment of FIG. 1. 5 are end views of other modifications from the side elevation, would provide an access into the angles and the folds.

Thus, by a back and forth motion simultaneous with a circular rounding motion, the brush provides a more effeetive scrubbing than is possible for the same number of strokes by the use of a conventional square brush. 'I he handle frame which can be disengaged from the brush by a simple motion forward or backward provides a very important ancillary function, namely the supply of predetermined or minimal quantity of soap or antiseptic detergent and a mechanical nail cleaner to work for the sub-cuticular debris. ln effect, the handle arrangement insures that a stiff cuticular cleaning device is available rather than depending upon the orange stick mentioned above.

This arrangement also provides two unique features. First, the cylindrical brush can be disengaged and autoclaved for reuse or if made from the inexpensive synthetic bristles described later on, disposed to prevent subsequent contamination especially in situations involving highly contagious mechanical absorption. Secondly, the disenga'ged handle frame can likewise be autoclaved separately or be replaced by a second handle for additional charge of soap or antiseptic detergent as would be required by special regimen for preoperative preparation.

FIG. 2 illustrates a top View of the principal compolients shown in FIG. l. In particular, the cylindrical bristle back 1 is made in a manner to provide sufficient edge bristles 12, 13 of design such that each of the interdigital folds are thoroughly and completely reached.

The ,brush is cylindrical in shape, preferably measuringmZl/z inches in diameter and 41/2 inches in length. A T-shaped handle 4 runs the entire length of the cylinder. Within the upper limb of the T-handle is a cylinrical space, as Shown in FIG. l, with a track on each side serving to admit specially made cartridge of soap or antiseptic cleansing or detergent solution. On the top part of the handle are one or more self-contained, 'recessed points 6, 6' at each end to be used for cleaning 4tli underpart of the nails. They are recessed to preveilt scratching of the skin during scrubbing and to avoid 'penetration through the package in which it is preferably contained in an aseptic condition for storage or prior to use.

' In actual use, the brush is removed from its sterile package. The soap cartridge is already inserted in its 'special receptacle directly from the manufacturer or may be inserted at the time of scrubbing. By squeezing the soft plastic tube projecting slightly above the surface of 4the handle, the contained soap or other aseptic scrubbing solution is squeezed onto the brush. Alternatively spaced hollow pins 20 may be incorporated in the tube, which are adapted to pierce the container and to provide a more uniform supply of soap to the interior bristles.

Next, the fingernails are cleaned with the built-in recessed projections 6 at each end of the handle. Each finger is then cleaned separately by inserting the finger within the bristle-lined lumen or tube and with a push and pull action the entire finger can be cleansed in one operation with all areas receiving equal scrubbing. The tubular outer portion of the brush fits well and reaches all parts of the web angles and proximal surfaces of the fingers and are similarly cleansed by a to-and-fro as well as a partly circular rotating action. The remainder of the scrubbing over the arms and hands is performed in the usual prescribed regimen. Following the completion of the scrubbing operation the brush may be disengaged from the handle carrier and subjected to additional autoclaving or if necessary disposal.

FIGS. 3, 4 and 5 show modifications of the invention.

FIG. 3 shows a one-piece design with the handle 25 integral with the brush. The handle may be shaped or tapered to provide a better hand grip as shown by han- 4 embodiments of FIGS. 3 and 4 other cleaning dle 19 in 1ElG. 4. The have provisions for mounting a soap or liquid cartridge or container 7.

FlG. 5 shows a modification of the invention having a pair of longitudinal handles 26, 27 extended out radially from the hollow body Z3 of the brush. The diameter of this modification should be sufficiently small so that the handles 26 and 27 may be grasped between the thumb and other fingers. The length of the brushes is not critical and is preferably about 4 or 5 inches long.

During a ten minute scrubbing procedure, which is the accepted period of time for preparation of the hands and arms prior to surgery, there are in the range of 1800l to 2400 separate strokes given to the lingers, hands and arms. It was observed that approximately of these strokes involved the cleansing of the fingers and interdigital spaces. By the use of the unique bristle-lined lumen of this new brush, which entirely encompasses and in one stroke cleanses an entire digit, the number of strokes and therefore the amount of time can be reduced by as much as 75%. Since four individual operations (strokes) are normally required to cleanse each digit with the conventional brush, only one is now necessary. It logically follows therefore that thev length of time normally necessary for the prescribed pre-operative preparation of the hands and arms with the conventional square brush can be reduced with the presentl improved surgical scrub brush and yet achieve identical results. Also, by using the present improved surgical brush the full ten minutes as is routine with a conventional scrub brush, there is a statistically significant increase in elficiency in the preparation of the lingers and hands, as reiieceted in the much lower bacterial andV debris count following its use.

A unique `feature of this invention is to provide a surgical scrub brush whose design conforms automatically to those parts that it is intended to clean.

A principal feature of this invention is the time-saving element involved in this particular device. Not generally appreciated is the fact that in the preoperative schedule, the surgeons time, as well as the time of the principal surgical assistants, can often be highly important. In one sense, extensive surgical preparation often represents a drain of physical energy on the surgeon which is, of course, necessary for safe surgical preparation. In another sense, particularly where rapid or emergency operations are necessary and where time is of utmost importance, it has been shown that the composite brush of this invention can reduce the presurgical preparation by a matter of many minutes or fraction of an hour. These two contributory aspects, namely, saving' the energy for more delicate surgical operations on the one hand, and, secondly, providing very immediate attainment of surgical cleanliness, are illustrated by the Vfollowing two examples in which these aspects are implied.

Example 1.-This example provides an evaluation of the degree of asepsisdeveloped on the hands of a resident, practicing thoracic surgeon employingreplicate operational procedures on a routine basis for a period of l2 days alternating between the prescribed regimen with a square brush and the procedure or scrubbing usingV the brush of this invention. Insofar as is humanly practicable, a consistent stroke and motion pattern was used in each of the daily twelve consecutive scrubbings lasting for a period of six minutes. Following each scrubbing operation and immediately prior to the ensuing surgical task, the hands up to the wrist were inserted in a tubular 'beaker of sterile, distilled water specially formulated with a surface active agentof non-germicidal activity supplemented with a .5% of agar-agar for nutrient purposes and .5% polyvinyl alcohol to increase the viscosity of the immersion solution. After withdrawing of the scrubbed hands from this special solution, the contents -were closed by means of a light parchment cap and a1- lowed to incubate at 37 C. for 96 hours. A bacterial 5 and `debridal count was made microscopically in order to compare the effectiveness of the two regimens or the two procedures involving conventional square brush and the -brush of this invention. The count for each of these two procedures is made for each of the twelve scrubbings and averaged with an appropriate calculated standard of deviation as shown in the following table.

Bacterial Debris No. of Count 1 Count 2 Procedure Scrubbing Av. SD Av. SD

Conventional square brush 6 67:1:18 93:1:20 Brush of this invention 6 14:1:3 165:4

1 Number per 100 ml. (now standard test) seen on microscopic slide.

2 Number per 100 ml. on micropore filter.

SD: Standard deviation.

This table illustrates the significant decrease in bacterial and debris count attained by the use of the more eiicient brush of this invention.

Example 2.-This example illustrates the eiciency of the scrubbing operation employing this particular brush as a valuable feature of time saving. In this experiment the scrubbing operations were terminated after each one minute period. As in Example 1 following this scrubbing the hands were immersed up to the wrists in the special solution described in Example 1 for the bacterial and debridal count.

Bacterial Count Debris Count Scrubbing Time (minutes) 1 Conven- Brush Stional of This (A) (B) quare ven- Brush tion (A) (B) 1 Carried out on separate days.

The above data again illustrate emphatically the very rapid time wise removal of the bacteria and debris attained by the ybrush Idescribed in this invention. In iboth examples the conventional nylon type |bristle brush has been used.

The efficacy of the brush of this invention has also been shown in other ways including the inspection of the folds or angles between the fingers by removing topical, residual unscrubbed debris employing moistened plaques of thin polyvinyl alcohol films and examining these under the microscope. In several instances n which the conventional square brush -was employed, there was marked evidence of skin regions that were completely unaffected. This was particularly `demonstrated by experiments in which the folds and the angles were deliberately painted with a fluorescent dye. Ultra violet light was then employed to detect dye residues after use of the conventional square brush. In several instances the markings were not completely removed. However, under identical test conditions, 'but employing the present improved surgical scrub brush, all 'traces of dye were removed in persistent scrubbings of two to six minutes duration.

Of particular importance to this invention is the discovery that certain bristles of the synthetic type apparently having a nonpolar chemical configuration and low c0- eflicient of friction were effective in very rapid removal of the skin bacteria and debris. An examination of the brushes made of the usual polar type of bristles including polyamides and natural bristles in contrast with the synthetic `bristles made of polyethylene, polypropylene, and polytetrafiuoroethylene showed considerably less retention of the bacteria and debris on the bristles. This unexpected difference has emphasized the unique value of the latter type of bristles for the construction of the brush of this invntion. While some degree of stiffness has been sacrificed in converting from ythe conventional natural or polyamide bristles to the non-polar type of bristles, this has been offset by the markedly decreased bacterial and debris count such as indicated in Examples 1 and 2. It is therefore the intent of this invention to emphasize utility of the substantially non-polar polymeric filament components of the surgical brush described in FIGS. 1, 2 and 3. In addition, autoclavable filaments of polyethylene including crosslinked by chemical and high energy radiation are particularly suited for the construction of the brush. Furthermore, the availability of these bristle materials in relatively inexpensive constructions makes them particularly suitable for disposal following each presurgical regimen and thus minimize any chance contamination that may occur as a result of embedded viable bacteria in the skin or Iskin folds. Although the invention has been described in detail, these have been by Way of explanation rather than limitation.

Many modifications are possible, including supporting constructions using additional components without de parting from the spirit of the invention.

We claim:

A hand and finger brush comprising a hollow tube member, at least as long as a finger,

a plurality of bristles mounted on the outer surface of said tube,

a plurality of bristles said tube,

a handle connected to said tube, and extending outwardly over said exterior bristles and means to supply cleaning material to the bristles of said brush and onto a mounted on the inner surface of progress.

References Cited in the file of this patent UNITED STATES PATENTS OTHER REFERENCES Modern Plastics, vol. 31, No. l0, June 1954 (pp. 122` 123 relied on). 

